Types of Male Breast Reduction

Gynecomastia is a condition where the male breast becomes enlarged due to excessive glandular tissue. Often referred to colloquially as "man boobs", it is usually caused by an imbalance of the hormones estrogen and testosterone, but other factors include a health condition such as liver disease, low testosterone production, a thyroid problem, and certain medications or illicit drugs that raise estrogen levels. Gynecomastia slightly increases a man's risk for breast cancer.

Pseudogynecomastia is an enlarged male breast caused by excessive fat tissue.. It occurs in many men as they become older, in boys as they reach adolescence, and in young men who are obese. It can also develop in men who are on certain medications or those who have lost a considerable amount of weight.

Gynecomastia may go away on its own or with medical treatment, depending on its cause. Surgery is an option if it persists. There are two surgical approaches for treating gynecomastia: liposuction and reduction mammoplasty. Both are invasive surgeries.

Liposuction is a fat removal process that deals only with subcutaneous fat (the fat directly beneath the skin). During the outpatient procedure performed under local anesthesia, a narrow tube-shaped surgical instrument called a cannula is inserted into the targeted fat pocket through small incisions. The surgeon manipulates the cannula back and forth to break up the subcutaneous fat, and the fat is suctioned out through the cannula using a vacuum device.

Liposuction works well to remove excess fat in the chest area of men with pseudogynecomastia, although some of these men and men with true gynecomastia may also need surgery to remove excess breast tissue or loose skin.

That surgery is called reduction mammoplasty. Mammoplasty refers to any surgical procedure that changes the size of the breasts. Reduction mammoplasty is also usually performed as an outpatient procedure, but general anesthesia or intravenous sedation is used. The incisions used for gynecomastia are usually made around the nipple or under the armpit to keep them as hidden as possible. The surgeon then removes the unwanted breast tissue and closes up the incisions. Extremely large nipples can also be reduced at this time, if the patient wishes.

Patients who undergo liposuction and/or reduction mammoplasty need to wear a compression garment to compress the chest for about one week after surgery to minimize swelling and promote healing. This vest-like garment is made of an elastic material similar to spandex or an elastic bandage. A plastic tube that drains accumulated fluids in the treatment area is usually removed within a few days after surgery. Patients may return to work within a few days, depending on their activity level, but sports and other vigorous activities are banned for 6 weeks after surgery. Discomfort during recovery is usually mild. Scars are usually unnoticeable once they've healed completely.

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